Details
Category: Volume 09 Issue 06 June 2021
Hits: 1182

Title: COVID-19 Associated Acute Delirium

Authors: Dr Roy Sumeet Swapan, Dr Raghav Kapoor, Dr Goel Nikita

 DOI: https://dx.doi.org/10.18535/jmscr/v9i6.11

Abstract

Novel coronavirus disease (COVID-19), caused by SARS-CoV-2, which has been established as a worldwide pandemic, is now known to cause life-threatening respiratory, cardiovascular, and neurological complications. It’s consequence on other organs is yet to be understood even after so many months have passed. The neuropsychiatric events following COVID-19, such as delirium, have been underreported and the etiology is poorly understood. The primary etiology of social stressor is believed to be the reason. A few documented reports have been published and hence there is no known specific management.

We are presenting a case report of an individual who presented with acute onset Delirium a few days after recovery from COVID infection. Wide range of investigations were done with no definite etiology or known pathophysiology. This phenomenon is self-resolving with no apparent consequence till date.

References

  1. Rentero D, Juanes A, Losada CP, et al. New-Onset psychosis in COVID-19 pandemic: a case series in Madrid. Psychiatry Res 2020;290:113097.
  2. Ferrando SJ, Klepacz L, Lynch S, et al. COVID-19 psychosis: a potential new neuropsychiatric condition triggered by novel coronavirus infection and the inflammatory response? Psychosomatics 2020. doi:10.1016/j.psym.2020.05.012. [Epub ahead of print: 19 May 2020].
  3. Galynker I, Ieronimo C, Perez-Acquino A, et al. Panic attacks with psychotic features. J Clin Psychiatry 1996;57:402–6.
  4. Smith CM, Komisar JR, Mourad A, et al. BMJ Case Rep 2020;13:e236940. doi:10.1136/bcr-2020- 236940
  5. Sheng B, Cheng SKW, Lau KK, et al. The effects of disease severity, use of corticosteroids and social factors on neuropsychiatric complaints in severe acute respiratory syndrome (SARS) patients at acute and convalescent phases. Eur Psychiatry 2005;20:236–42.
  6. Lee DTS, Wing YK, Leung HCM, et al. Factors associated with psychosis among patients with severe acute respiratory syndrome: a case-control study. Clin Infect Dis 2004;39:1247–9
  7. Brown ES, Chandler PA. Mood and cognitive changes during systemic corticosteroid therapy. Prim Care Companion J Clin Psychiatry 2001;3:17–21.
  8. Cheng SK-W, Tsang JS-K, Ku K-H, et al. Psychiatric complications in patients with severe acute respiratory syndrome (SARS) during the acute treatment phase: a series of 10 cases. Br J Psychiatry 2004;184:359–60.
  9. Kim H-C, Yoo S-Y, Lee B-H, et al. Psychiatric findings in suspected and confirmed middle East respiratory syndrome patients Quarantined in hospital: a retrospective chart analysis. Psychiatry Investig2018;15:355–60.
  10. Kępińska AP, Iyegbe CO, Vernon AC, et al. Schizophrenia and influenza at the centenary of the 1918-1919 Spanish influenza pandemic: mechanisms of psychosis risk. Front Psychiatry 2020;11:72
  11. Kim H-C, Yoo S-Y, Lee B-H, et al. Psychiatric findings in suspected and confirmed middle East respiratory syndrome patients Quarantined in hospital: a retrospective chart analysis. Psychiatry Investig2018;15:355–60.
  12. Mak IWC, Chu CM, Pan PC, et al. Long-Term psychiatric morbidities among SARS survivors. Gen Hosp Psychiatry 2009;31:318–26.
  13. Severance EG, Dickerson FB, Viscidi RP, et al. Coronavirus immunoreactivity in individuals with a recent onset of psychotic symptoms. Schizophr Bull 2011;37:101–7.
  14. Wilson MP, Pepper D, Currier GW, et al. The psychopharmacology of agitation: consensus statement of the American association for emergency psychiatry project beta psychopharmacology Workgroup. West J Emerg Med 2012;13:26–34.
  15. Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? neuropsychiatric symptoms and potential immunologic mechanisms. Brain BehavImmun2020;87:34–9
  16. Gordon DE, Jang GM, Bouhaddou M, et al. A SARS-CoV-2 protein interaction map reveals targets for drug repurposing. Nature 2020;583:459–68.
  17. Weston S, Coleman CM, Haupt R, et al. Broad anti-coronaviral activity of FDA approved drugs against SARS-CoV-2 in vitro and SARS-CoV in vivo. bioRxiv 2020.
  18. The American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia. Available: https://www.psychiatry.org/psychiatrists/practice/ clinical-practice-guidelines2019 [Accessed 30 May 2020].
  19. Ferrando, Stephen J et al. “COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response?.” Psychosomatics vol. 61,5 (2020): 551-555. doi:10.1016/j.psym.2020.05.012
  20. Upthegrove R., Khandaker G.M. Cytokines, oxidative stress and cellular markers of inflammation in schizophrenia. Curr Top BehavNeurosci. 2019;44:49–66
  21. Mehta P., Mcauley D.F., Brown M., Sanchez E., Tattersall R.S., Manson J.J. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395:1033–1034
  22. Troyer, Emily A et al. “Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms.” Brain, behavior, and immunity vol. 87 (2020): 34-39. doi:10.1016/j.bbi.2020.04.027

Corresponding Author

Dr Roy Sumeet Swapan